Provider Demographics
NPI:1427213552
Name:LEE-REGIER, KRISSA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISSA
Middle Name:
Last Name:LEE-REGIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KRISSA
Other - Middle Name:LEE
Other - Last Name:RIPPEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3815 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3815 CHARLES ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-1206
Practice Address - Country:US
Practice Address - Phone:402-561-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE795101YM0800X
NE1191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE272021LEMedicare PIN